Sun exposure and melanoma risk at different latitudes: a pooled analysis of 5700 cases and 7216 controls

被引：185

作者：

Chang, Yu-mei ^{[1
]}

Barrett, Jennifer H. ^{[1
]}

Bishop, D. Timothy ^{[1
]}

Armstrong, Bruce K. ^{[2
]}

Bataille, Veronique ^{[3
,4
]}

Bergman, Wilma ^{[5
]}

Berwick, Marianne ^{[6
]}

Bracci, Paige M. ^{[7
]}

Elwood, J. Mark ^{[8
]}

Ernstoff, Marc S. ^{[9
]}

Gallagher, Richard P. ^{[8
]}

Green, Adele C. ^{[10
]}

Gruis, Nelleke A. ^{[5
]}

Holly, Elizabeth A. ^{[7
]}

Ingvar, Christian ^{[11
]}

Kanetsky, Peter A. ^{[12
,13
]}

Karagas, Margaret R. ^{[14
,15
]}

Lee, Tim K. ^{[8
]}

Le Marchand, Loic ^{[16
]}

Mackie, Rona M. ^{[17
]}

Olsson, Hakan ^{[18
]}

Osterlind, Anne

Rebbeck, Timothy R. ^{[12
,13
]}

Sasieni, Peter ^{[19
]}

Siskind, Victor ^{[10
]}

Swerdlow, Anthony J. ^{[20
]}

Titus-Ernstoff, Linda ^{[14
,15
,21
]}

Zens, Michael S. ^{[14
,15
]}

Newton-Bishop, Julia A. ^{[1
]}

机构：

[1] Leeds Inst Mol Med, Epidemiol & Biostat Sect, Leeds, W Yorkshire, England

[2] Univ Sydney, Sch Publ Hlth, Sydney, NSW 2006, Australia

[3] Kings Coll London, Twin Res & Genet Epidemiol Unit, London WC2R 2LS, England

[4] Hemel Hempstead Gen Hosp, Dept Dermatol, W Herts NHS Trust, Hemel Hempstead, Herts, England

[5] Leiden Univ, Dept Dermatol, Med Ctr, Leiden, Netherlands

[6] Univ New Mexico, Dept Internal Med, Albuquerque, NM 87131 USA

[7] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA

[8] British Columbia Canc Agcy, Canc Control Res Program, Vancouver, BC V5Z 4E6, Canada

[9] Dartmouth Hitchcock Med Ctr, Dept Med, Lebanon, NH 03766 USA

[10] PO Royal Melbourne Hosp, Queensland Inst Med Res, Brisbane, Qld, Australia

[11] Univ Lund Hosp, Dept Surg, S-22185 Lund, Sweden

[12] Univ Penn, Dept Biostat & Epidemiol, Philadelphia, PA 19104 USA

[13] Univ Penn, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA

[14] Dartmouth Med Sch, Dept Community & Family Med, Lebanon, NH USA

[15] Norris Cotton Canc Ctr, Lebanon, NH USA

[16] Univ Hawaii, Canc Res Ctr Hawaii, Honolulu, HI 96813 USA

[17] Univ Glasgow, Dept Publ Hlth & Hlth Policy, Fac Med, Glasgow G12 8QQ, Lanark, Scotland

[18] Univ Lund Hosp, Dept Oncol, S-22185 Lund, Sweden

[19] Barts & London Queen Marys Sch Med & Dent, Wolfson Inst Prevent Med, London, England

[20] Inst Canc Res, Epidemiol Sect, Sutton, Surrey, England

[21] Dartmouth Med Sch, Dept Pediat, Lebanon, NH USA

来源：

INTERNATIONAL JOURNAL OF EPIDEMIOLOGY | 2009年 / 38卷 / 03期

基金：

美国国家卫生研究院;

关键词：

Melanoma; recreational sun exposure; occupational sun exposure; total sun exposure; sunburn; solar keratoses; CUTANEOUS MALIGNANT-MELANOMA; MELANOCYTIC NEVI; ULTRAVIOLET-RADIATION; SUNLIGHT-EXPOSURE; ACTINIC KERATOSIS; DNA-REPAIR; SUNBURN; INTERMITTENT; SUNBEDS; LIGHT;

D O I：

10.1093/ije/dyp166

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Background Melanoma risk is related to sun exposure; we have investigated risk variation by tumour site and latitude. Methods We performed a pooled analysis of 15 case-control studies (5700 melanoma cases and 7216 controls), correlating patterns of sun exposure, sunburn and solar keratoses (three studies) with melanoma risk. Pooled odds ratios (pORs) and 95% Bayesian confidence intervals (CIs) were estimated using Bayesian unconditional polytomous logistic random-coefficients models. Results Recreational sun exposure was a risk factor for melanoma on the trunk (pOR 1.7; 95% CI: 1.4-2.2) and limbs (pOR 1.4; 95% CI: 1.1-1.7), but not head and neck (pOR 1.1; 95% CI: 0.8-1.4), across latitudes. Occupational sun exposure was associated with risk of melanoma on the head and neck at low latitudes (pOR 1.7; 95% CI: 1.0-3.0). Total sun exposure was associated with increased risk of melanoma on the limbs at low latitudes (pOR 1.5; 95% CI: 1.0-2.2), but not at other body sites or other latitudes. The pORs for sunburn in childhood were 1.5 (95% CI: 1.3-1.7), 1.5 (95% CI: 1.3-1.7) and 1.4 (95% CI: 1.1-1.7) for melanoma on the trunk, limbs, and head and neck, respectively, showing little variation across latitudes. The presence of head and neck solar keratoses was associated with increased risk of melanoma on the head and neck (pOR 4.0; 95% CI: 1.7-9.1) and limbs (pOR 4.0; 95% CI: 1.9-8.4). Conclusion Melanoma risk at different body sites is associated with different amounts and patterns of sun exposure. Recreational sun exposure and sunburn are strong predictors of melanoma at all latitudes, whereas measures of occupational and total sun exposure appear to predict melanoma predominately at low latitudes. Keywords Melanoma, recreational sun exposure, occupational sun exposure, total sun exposure, sunburn, solar keratoses

引用

页码：814 / 830

页数：17

共 39 条

[21]

Kanetsky PA, 2001, CANCER EPIDEM BIOMAR, V10, P509

[22] Sensitivity to sunburn is associated with susceptibility to ultraviolet radiation-induced suppression of cutaneous cell-mediated immunity [J].

Kelly, DA ;

Young, AR ;

McGregor, JM ;

Seed, PT ;

Potten, CS ;

Walker, SL .

JOURNAL OF EXPERIMENTAL MEDICINE, 2000, 191 (03) :561-566

[23] The influence of painful sunburns and lifetime sun exposure on the risk of actinic keratoses, seborrheic warts, melanocytic nevi, atypical nevi, and skin cancer [J].

Kennedy, C ;

Bajdik, CD ;

Willemze, R ;

de Gruijl, FR ;

Bavinck, JNB .

JOURNAL OF INVESTIGATIVE DERMATOLOGY, 2003, 120 (06) :1087-1093

[24]

Kripke M L, 1996, Exp Dermatol, V5, P173, DOI 10.1111/j.1600-0625.1996.tb00113.x

[25]

Lachiewicz AM, 2008, J INVEST DERMATOL, V128, P243, DOI [10.1038/sj.jid.5701028, 10.1038/jid.2008.18]

[26] ULTRAVIOLET-INDUCED DNA-REPAIR SYNTHESIS IN LYMPHOCYTES FROM PATIENTS WITH ACTINIC KERATOSIS [J].

LAMBERT, B ;

RINGBORG, U ;

SWANBECK, G .

JOURNAL OF INVESTIGATIVE DERMATOLOGY, 1976, 67 (05) :594-598

[27] Sun exposure, diet, and melanoma in Hawaii Caucasians [J].

Le Marchand, Loic ;

Saltzman, Barbara S. ;

Hankin, Jean H. ;

Wilkens, Lynne R. ;

Franke, Adrian A. ;

Morris, Steven J. ;

Kolonel, Laurence N. .

AMERICAN JOURNAL OF EPIDEMIOLOGY, 2006, 164 (03) :232-245

[28] WinBUGS - A Bayesian modelling framework: Concepts, structure, and extensibility [J].

Lunn, DJ ;

Thomas, A ;

Best, N ;

Spiegelhalter, D .

STATISTICS AND COMPUTING, 2000, 10 (04) :325-337

[29] Determinants of BRAF mutations in primary melanomas [J].

Maldonado, JL ;

Fridlyand, J ;

Patel, H ;

Jain, AN ;

Busam, K ;

Kageshita, T ;

Ono, T ;

Albertson, DG ;

Pinkel, D ;

Bastian, BC .

JOURNAL OF THE NATIONAL CANCER INSTITUTE, 2003, 95 (24) :1878-1880

[30] AN ADDITION TO THE CONTROVERSY ON SUNLIGHT EXPOSURE AND MELANOMA RISK - A META-ANALYTICAL APPROACH [J].

NELEMANS, PJ ;

RAMPEN, FHJ ;

RUITER, DJ ;

VERBEEK, ALM .

JOURNAL OF CLINICAL EPIDEMIOLOGY, 1995, 48 (11) :1331-1342

← 1 2 3 4 →